Comments
A sentinel health event (occupational) associated with exposure to TNT, benzene, and ionizing radiation; [Mullan] Reported causes of aplastic anemia in the occupational setting include benzene, TNT, lindane, pentachlorophenol, DDT, arsenic, ethylene glycol monomethyl ether, and ethylene glycol monobutyl ether. [LaDou, p. 272] The known environmental causes of aplastic anemia are trinitrotoluene, dinitrotoluene, benzene, lindane, ionizing radiation, arsenic, and alkylating agents. Suspected causes are dioxin, chlordane, DDT, ethylene glycol ethers, paradichlorobenzene, and pentachlorophenol. [Rosenstock, p. 465t] See the section on Other Hematotoxins: Lead, Arsenic, Radium, Ethylene Oxide, Glycol Ethers, Trinitrotoluene, Aromatic Solvents, 1,3-Butadiene, Chlordane/Heptachlor, and Phenoxy Herbicides. [Sullivan, p. 757-759] The OSHA benzene standard requires air monitoring and medical surveillance when workers are exposed above the action level of 0.5 ppm 30 or more days per year. Workers may be exposed to benzene in chemical, shoe, pesticide, detergent, plastic, and rubber manufacturing. The standard applies to workers who repair or maintain gasoline or jet fuel tanks and also to workers who refine petroleum, dispense gasoline indoors, and operate bulk storage facilities that lack vapor control systems. [OSHA] Look at exposures in the previous 6 months in investigations of environmental/occupational causes of aplastic anemia. [Rosenstock, p. 466] For radiation, the threshold dose for bone marrow toxicity is approximately 125 rads. "In recognized occupational cases, aplastic anemia has been diagnosed soon after the responsible exposure." [APHA, p. 84] "Among workers who have been exposed to atmospheric concentrations of benzene in excess of 300 ppm for at least 1 year, as many as 20% will acquire pancytopenia or aplastic anemia." [LaDou, p. 304]